Department for Digital, Culture, Media and Sport

Musicians: Visas and Work Permits

Lord Clement-Jones: To ask Her Majesty's Government what discussions they have had since 1 January with (1) the EU, and (2) individual EU Member States about introducing work permits and visas to enable UK musicians and their crew to be paid for performances in the EU.

Lord Clement-Jones: To ask Her Majesty's Government what assessment they have made of the effect that additional visa and work permit restrictions will have on the number and proportion of UK musicians who perform in Europe.

Lord Clement-Jones: To ask Her Majesty's Government what assessment they have made of the importance of touring in the EU for the career development of UK musicians.

Baroness Barran: Touring is a vital part of the careers of musicians, performers and their support staff, providing not only an important income stream, but also enriching opportunities for cultural exchange across the world. Being outside the European Union does not change this. It does, however, mean practical changes on both sides of the Channel that will require understanding and adaptation.We are now working urgently across government and in collaboration with the music and wider creative industries, including through a new working group, to help understand and address these issues so that touring in Europe can resume with ease as soon as it is safe to do so.As part of this work DCMS is working with the Foreign Office and others across government to consider how best to take forward engagement with EU Member States on these issues. It is within Member States’ gift to improve their arrangements and we will engage with bilateral partners to find ways to make life easier for those working in the creative industries in countries across the EU.

Ministry of Justice

Suicide: Terminal Illnesses

Baroness Hayman: To ask Her Majesty's Government what discussions they have had with coronersabout the number of people with terminal illnesses who die as a result of suicide per year.

Lord Wolfson of Tredegar: The Ministry of Justice oversees the legal framework that governs the coronial system but does not have operational responsibility for coroner services. Ministers and officials meet with the Chief Coroner, individual coroners and local authorities from time to time to discuss a range of issues including suicide. We have not had recent discussions on the issue or the number of people with terminal illnesses who take their own lives.

Cabinet Office

Suicide: Terminal Illnesses

Baroness Royall of Blaisdon: To ask Her Majesty's Government what estimate they have made of the proportion of deaths per year recorded as suicide where the person had been diagnosed with a terminal illness.

Baroness Royall of Blaisdon: To ask Her Majesty's Government what consideration they have given to collecting data on deaths recorded as suicides where a terminally ill person has taken their own life.

Baroness Royall of Blaisdon: To ask Her Majesty's Government what estimate they have made of the number of people per yearwho die as a result of suicide and, prior to their deaths, (1) had been diagnosed with, and (2) had been treated for (a) cancer, (b) neurological disease, (c) respiratory disease, or (d) heart or circulatory disease, in the previous 12 months.

Lord True: The information requested falls under the remit of the UK Statistics Authority. I have therefore asked the Authority to respond. Professor Sir Ian Diamond | National StatisticianThe Baroness Royall of BlaisdonHouse of Lords London SW1A 0PW10 February 2021 Dear Baroness Royall, As National Statistician and Chief Executive of the UK Statistics Authority, I am responding to your Parliamentary Questions asking what estimate has been made of proportion of deaths per year recorded as suicide where the person had been diagnosed with a terminal illness (HL13017); what consideration has been given to collecting data on deaths recorded as suicides where a terminally ill person has taken their own life (HL13018); and the number of people per year who die as a result of suicide and, prior to their deaths, (1) had been diagnosed with, and (2) had been treated for (a) cancer, (b) neurological disease, (c) respiratory disease, or (d) heart or circulatory disease, in the previous 12 months (HL13019). The Office for National Statistics (ONS) publishes annual suicide death registration statistics for England and Wales as part of our annual statistical release for the UK[1],[2]. The latest available figures were published by the ONS in September 2020 and covered calendar years up to 2019. The information we hold on deaths is limited to what is recorded at death registration, which is based primarily on the death certificate by a doctor, or information about the cause and circumstances of the death provided by a coroner. We are unable at present to collect data or provide figures specifically on suicide where the person had been diagnosed with a terminal illness, since information on the deceased’s circumstances prior to death, such as diagnosis or treatment, is not among the particulars generally recorded on the death certificate. Table 1 below shows the number of deaths where the underlying cause was suicide, and where the conditions requested where mentioned as contributory causes for the latest available year. It is important to note that death certificates do not record all health conditions the deceased might have had if they did not contribute directly or indirectly to the cause of death. The ONS has acquired a range of other datasets, including Hospital Episode Statistics and General Practitioner records, which will be linked to mortality records. It is possible that we will be able to use such data linkages in the future to understand how many people who die by suicide had a terminal illness.  Yours sincerely,Professor Sir Ian Diamond Table 1: Number of deaths where the underlying cause was suicide and where cancer, neurological, respiratory or heart disease was mentioned as a contributory cause; England and Wales, registered in 2019[3][4][5][6][7]1,2,3,4,5 Cause of deathDeathsAll Suicide5,691...of which mentioned cancer56...of which mentioned neurological disease264...of which mentioned respiratory disease168…of which mentioned heart disease321Source: ONS   [1]https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/latest[2] Due to operational difficulties, suicides registered in 2019 in Northern Ireland and Scotland were unavailable at the time of analysis, and so last year’s annual release is for England and Wales only. The ONS will update the UK figures at a later stage.[3] The National Statistics definition of suicide is given in Box 1 below for deaths registered since 2001.[4] The definitions used to define the selected contributory causes are given in Box 2 below.[5] Figures for England and Wales (area code K04000001) include deaths of non-residents, based on postcode boundaries as of November 2020.[6] Figures are for deaths registered, rather than deaths occurring in each calendar year. Due to the length of time it takes to complete a coroner’s inquest, it can take months or even years for a suicide to be registered. More details can be found in the ‘Suicide Registrations In The UK’ statistical bulletin.[7] A single death certificate may contain a number of contributory causes. For this reason, the categories above are not mutually exclusive. Box 1: International Classification of Diseases, Tenth Revision (ICD-10) codes used to define suicide ICD-10 codesDescriptionNotesX60-X84Intentional self-harmPersons aged 10 years and above   Y10-Y34Injury/poisoning of undetermined intentPersons aged 15 years and above; excludes Y33.9 where coroner’s verdict was pending for the years 2001 - 2006  Box 2: International Classification of Diseases, Tenth Revision (ICD-10) codes used to define the selected contributory causes ICD-10 CodesDescriptionC00-D48CancerG00-G99Neurological DiseaseJ00-J99Respiratory DiseaseI00-I99Heart Disease

UK Internal Trade: Northern Ireland

Baroness Ritchie of Downpatrick: To ask Her Majesty's Government what assessment they have made of the existing flexibilities and procedures for problem solving contained within the Protocol on Ireland/Northern Ireland, in relation to trading matters between Great Britain and Northern Ireland.

Lord True: As set out in our Command Papers, the UK Government has, at all times, taken forward a pragmatic and proportionate approach, drawing upon all available flexibilities to implement the Protocol without causing undue disruption to lives and livelihoods. The EU’s actions on 29 January, however, profoundly undermined the operation of the Protocol and cross-community confidence in it. That is why it is now urgent for work to be taken forward to address all outstanding issues, to reassure all parties in Northern Ireland. The letter sent to Vice-President Sefcovic by the Chancellor of the Duchy of Lancaster, on 2 February, sets out the baseline set of issues that the UK Government consider must be addressed in this regard. The Joint Committee co-chairs met again on 11 February as part of this work.

Census: Staff

Lord Greaves: To ask Her Majesty's Government what will be the duties ofthose employed to carry out the census canvass in May 2021.

Lord True: The information requested falls under the remit of the UK Statistics Authority. I have therefore asked the Authority to respond.  Professor Sir Ian Diamond | National StatisticianThe Lord GreavesHouse of LordsLondonSW1A 0PW10 February 2021 Dear Lord Greaves As National Statistician and Chief Executive of the UK Statistics Authority, I am responding to your Parliamentary Question asking what the duties will be of those employed to carry out the census canvass in May 2021 (HL12955). Census 2021 will be a digital-first census and the Office for National Statistics (ONS) will be encouraging people to respond online if they can on their mobile phones, laptops, PCs or tablets, and providing a comprehensive range of support (including paper questionnaires) for those who are not able to complete the census online. The ONS expects 70 percent of households to respond without needing a reminder letter or visit from field staff. However, where it is necessary for the field staff to be involved and carry out their assigned duties, please be assured that safety is our number one concern. For Census 2021, due to take place on the 21 March 2021, the ONS will have up to 40,000 census field staff working across England and Wales. The majority of the field force, who are ONS staff, are due to start the main follow-up work following Census day and no field staff will be knocking on doors until after that day. An initial tranche of field staff is due to start earlier than this, undertaking tasks that do not require them to interact with members of the public nor knock on doors of households. They will be out and about from 8 March performing duties such as checking addresses of undelivered mail, understanding the local area and understanding the access to buildings etc. Following Census day, field staff will start following up only those households who have not yet responded to the initial invitation and reminder letters. The primary role of these field officers is to give help and encouragement to those who have not yet filled in their census questionnaire online or on paper, and to direct them to the support services they need. Field staff will never enter people’s houses; they will be supplied with Personal Protective Equipment (PPE), will always be socially distanced and will work in line with all government guidance. All field staff will have been instructed in how to follow a precise door knocking routine to maximise safety for themselves and the public. Field officers will record the status of their visits by recording outcomes on the electronic Field Work Management Tool which has been developed for this purpose. A few examples of the many possible outcomes would be: they may record if the property is derelict, there was no answer (so they left a card), there was a hard refusal to complete. Officers can also collect paper questionnaires and post them for a household if the householder has completed one but is unable to post the return (for example, if the householder is housebound and has no family/friends to post the return for them). There are also field officers that are responsible for encouraging census returns from communal establishments (CEs), who will start this work on 23rd February. The CEs will be sent out an information pack by post and then the CE officers will contact the managers of each of them. They will discuss with the managers of each establishment the best way to enumerate and they will request an invitation to visit in a COVID secure way, that will follow the protocols established by that establishment, to hand deliver the Census packs to a member of the CE staff, as laid out in regulations. They will always follow local and central government guidelines. There is not a need for CE officers to meet with the residents of the establishment, as the managers of the CEs will organise for the census forms to be filled in by each of the residents. For more detailed information on ONS field staff roles, the ONS has published a Local Authority Partnership Guide[1] which includes a timeline of key activities during the Census 2021 operation (section 3), factsheets on field staff roles and responsibilities (section 7.2), recruitment allocation and dates for field staff (section 7.3). The health and safety of census field staff and the public are of the utmost importance to the ONS. Prior to going out into the field, all field staff will be given comprehensive COVID-19 training. This will include detailed guidance on how to use the PPE provided, in addition to the other control measures the ONS has established to ensure everyone’s safety. Full details of the safety measures are available on the Census 2021 jobs website.[2] As set out on that web page, the items of PPE issued to field staff will include, but is not limited to, face coverings, hand sanitiser and sanitising wipes.  Yours sincerely,Professor Sir Ian Diamond [1] https://census.gov.uk/assets/Census2021_A4_English_LocalAuthorityGuideVersionTwo_LAGD1-A.pdf[2] https://www.censusjobs.co.uk/covid-19-update/Local Authority Partnership Guide (pdf, 2462.2KB)

Department of Health and Social Care

Genito-urinary Medicine: Females

Baroness Grey-Thompson: To ask Her Majesty's Government why they are drafting a sexual and reproductive health strategy separately from a broader women’s health strategy.

Lord Bethell: The Government is committed to developing a Sexual and Reproductive Health Strategy, which we plan to publish in 2021. Development of the Sexual and Reproductive Health Strategy will be separate from the Women’s Health Strategy. However, Departmental officials are working closely together to ensure coherence between the Sexual and Reproductive Health and Women’s Health Strategies.Whilst details of the scope of the Sexual and Reproductive Health Strategy will be announced in due course, the topics considered for inclusion are broader than those that only affect women and we will be taking a whole population approach.

Speech and Language Therapy: Expenditure

Baroness Whitaker: To ask Her Majesty's Government what assessment they have made of the recommendation in the report by Children's Commissioner for England Still not safe:The public health response to youth violence, publishedon 6 February, forthe levelling up of spending on speech and language therapy services around the country.

Lord Bethell: We recognise that early language development is a significant health inequalities issue. Improving the number of children having good speech, language and communication skills by five years old is a national priority. Public Health England, with the Department for Education, is working to ensure that speech, language and communication needs are identified early on. We are monitoring the effectiveness of local joint arrangements through inspections by Ofsted and the Care Quality Commission. This will inform what further action is needed.

Coronavirus: Screening

Lord Walney: To ask Her Majesty's Government how many people in total have referred themselves for a NHS COVID-19 test; and what estimate they have made of the percentage of those people who self-referredwho had (1) a cough, (2) a temperature, (3) a loss of taste, (4) multiple symptoms, and (5) no symptoms.

Lord Bethell: We do not publish data in the format requested.

Care Homes: Coronavirus

Lord Alton of Liverpool: To ask Her Majesty's Government what assessment they have made of the decision for inspectors from the Care Quality Commission to be permitted to visit care homes without having undergone a COVID-19 test; and what evidence they have that this does not pose a risk to the residents of those homes.

Lord Bethell: Our first priority continues to be to reduce the risk of COVID-19 transmission in care homes and prevent future outbreaks, and to ensure the health and safety of both care workers and residents. To help reduce the risk of transmission, we have provided the Care Quality Commission (CQC) with test kits so CQC inspectors can undertake weekly polymerase chain reaction asymptomatic testing.Regular testing will help identify positive cases in the CQC’s inspectors without symptoms and enable action to be taken to limit the spread of the virus, supporting the CQC to continue their vital work in ensuring services meet fundamental standards of quality and safety. As with all testing policies, this remains under review.

Gender Recognition: Children

Lord Hunt of Kings Heath: To ask Her Majesty's Government, further to the report by the Care Quality Commission (CQC) Tavistock and Portman NHS Foundation Trust Gender identity services: inspection report, published on 20 January, and the statement that “separate from our inspection the High Court made a ruling on the 1 December 2020 around capacity and consent of children receiving hormone intervention for gender dysphoria”, what discussions they have had with the CQC about undertaking a further review of the Gender Identity Services at Tavistock and Portman NHS Foundation Trust.

Lord Hunt of Kings Heath: To ask Her Majesty's Government, further to the report by the Care Quality Commission (CQC) Tavistock and Portman NHS Foundation Trust Gender identity services: inspection report, published on 20 January, what assessment they have made of the statement in that report that the High Court ruling on 1 December 2020 about the capacity and consent of children receiving hormone interventions for gender dysphoria has not impactedits findings.

Lord Hunt of Kings Heath: To ask Her Majesty's Government what assessment they have made of (1) the report by the Care Quality Commission (CQC) Tavistock and Portman NHS Foundation Trust Gender identity services: inspection report, published on 20 January, and (2) of whether the report adequately considered the potential (a) risk to, and (b) long-term consequences for, children and young people of using medication intended to suppress puberty.

Lord Hunt of Kings Heath: To ask Her Majesty's Government what assessment they have made of (1) the press release by the Care Quality Commission (CQC) Care Quality Commission demands improved waiting times at Tavistock and Portman NHS Foundation Trust, published on 21 January, following its report Tavistock and Portman NHS Foundation Trust Gender identity services: inspection report, published on 20 January, and (2) the extent to which that press release reflects the findings of that report.

Lord Bethell: The High Court ruling of 1 December 2020 is subject to ongoing legal proceedings and as such we are unable to comment.The Care Quality Commission (CQC) shared the report on Tavistock and Portman NHS Foundation Trust Gender Identity Services (GIDS) with the Department prior to publication. The Department welcomes the report and is aware that the CQC will follow its normal process of monitoring and further inspection activity to further review the GIDS.The CQC continues engagement with NHS England and NHS Improvement on their independent review of gender services for children and young people, led by Dr Hillary Cass on how care can be enhanced. The review will report later in the year. This report will cover issues such as how and when young people are referred to specialist services, clinical decisions around how doctors and healthcare professionals support and care for patients with gender dysphoria.

Palliative Care

Lord Jones of Cheltenham: To ask Her Majesty's Government what plans they have to ensure patients continue to receive palliative care in the event that the hospice in which the patient is receiving treatment is forced to close due to its financial situation.

Lord Bethell: For this winter, recognising the exceptional challenges across health and social care and the specific challenges faced by hospices, significant additional funding is being made available. The COVID-19 Winter Plan set out additional funding of £125 million for hospices. This funding will be used to allow hospices to provide more beds for step down and community care through to March 2021.If despite this, a hospice should become financially unviable, the relevant clinical commissioning group (CCG) would be responsible, if closure resulted, for ensuring that alternative palliative care was in place for those populations it is responsible for. Most National Health Service funded hospice care is commissioned through CCGs. They are best placed to understand the needs of local populations and allocate funding for services to meet those needs from the overall resource allocations they receive.

Rehabilitation

Lord Brooke of Alverthorpe: To ask Her Majesty's Government what progress they have made towards producing a cross-addiction strategy which includes consideration of alcohol addiction.

Lord Bethell: Work on the cross-Government addiction strategy was paused during the COVID-19 pandemic and will resume this year. We will consider the evidence around alcohol dependence and harms and what further action is needed as this work progresses.

Coronavirus: Homelessness

Lord Black of Brentwood: To ask Her Majesty's Government how many homeless people have been admitted to hospital with COVID-19 in England.

Lord Bethell: This information is not held in the format requested. NHS Digital collects data on an admission, not individual, basis therefore an individual may be recorded more than once.

General Practitioners: Asylum and Migrants

The Lord Bishop of Durham: To ask Her Majesty's Government whatfunding has been provided to local authorities (1) to support (a) asylum seekers, (b) refugees, and (c) migrants, to register with a GP, and (2) to ensure thatthose peopleare factored into COVID-19 vaccination plans.

Lord Bethell: The COVID-19 vaccine is available free of charge to anyone living in England, including those here without permission. The terms under which general practices are commissioned to deliver vaccination services enable practices to vaccinate unregistered patients. Individuals who are not registered with a practice will therefore be able to access the vaccine in line with the priority groups outlined by the Joint Committee on Vaccination and Immunisations (JCVI). However, we would strongly encourage everyone to register so that they may be more easily invited for vaccination.NHS England and NHS Improvement are working with local government, voluntary, community and social enterprise partners and Healthwatch England on a campaign to support all people, particularly those in inclusion health groups, to register with a general practitioner (GP), which supports the identification of those who should be prioritised for the vaccine.NHS England and NHS Improvement fund health assessment services commissioned by clinical commissioning groups (CCGs) for destitute asylum seekers in the six Home Office-commissioned initial accommodation centres in England. In 2020/21, approximately £3.2 million was allocated to those CCGs. These services are in place to avoid disproportionate impact on local GP services and health assessment services may refer individuals for GP registration, which now includes prioritisation for COVID-19 vaccination in line with the JCVI’s advice.

Mental Illness: Children

The Marquess of Lothian: To ask Her Majesty's Government whether there has been an increase in the number of children arriving in accident and emergency departments with mental health issues since the start of the COVID-19 pandemic in England; what evidence they have collected that severe mental health conditions, including self-harm, eating disorders and overdoses, are now affecting children more severely and at younger ages; and what will be the priorities for Dr Alex George, the Youth Mental Health Ambassador, appointed by the Prime Minister on 3 February.

Lord Bethell: Provisional data for 2020/21 show that the number of children and young people attending accident and emergency departments in England with a diagnosis category of ‘psychiatric conditions’ fell substantially from 2,094 in March 2020 to 930 in April 2020. The latest information shows that they have since risen to 2,899 in November 2020 and that the levels of attendances between June and November 2020 remain broadly equivalent to the same period in the year before. We continue to work closely with the Department for Education, the National Health Service, Public Health England and a wide range of stakeholders to monitor the situation and support children and young people’s mental health and wellbeing. Dr Alex George will be joining the Department for Education’s mental health action group, which will look specifically at how young people’s mental health and wellbeing can be supported as they return to schools, colleges and universities.

Protective Clothing: Contracts

Lord Alton of Liverpool: To ask Her Majesty's Government which contracts they awarded to Ayanda Capital for the provision of personal protection equipment; what was the total value of such contracts; and what value of equipment supplied under such contracts were designated as (1) unfit for use in the NHS, (2) fit for clinical use only, (3) suitable for supply or sale to departments other than the Department of Health and Social Care, (4) suitable for sale or supply to third countries, and (5) required to be destroyed.

Lord Bethell: One contract has been awarded to Ayanda Capital by the Department with a value of £252 million. The Contract Award Notice and the contract has been published online at the Government’s Contracts Finder service which contains details of the value of each contract and the types of personal protective equipment (PPE) which have been ordered against each contract.Delivery is progressing for all the PPE items. All items of PPE undergo a rigorous technical assurance process before they can be released for use at which point decisions will be made about which healthcare setting they are suitable for or whether alternative settings need to be considered. Details of such decisions on individual contracts is regarded as commercially sensitive information as the Department may have to negotiate contract variations, which could include a refund or other form or redress against the supplier.

Health Services: Females

Baroness Grey-Thompson: To ask Her Majesty's Government what plans they have to create a comprehensive women’s health strategy which includes provisions for (1) improving sexual and reproductive health, and (2) menstrual wellbeing.

Baroness Grey-Thompson: To ask Her Majesty's Government whether plans to improve (1) diagnosis, and (2) treatment, of heavy menstrual bleeding will be included in (a) the sexual and reproductive health strategy, or (b) any broader women’s health strategy.

Lord Bethell: Work on both the sexual and reproductive health strategy and the women’s health strategy was paused due to COVID-19. For both, the work has now restarted. Heavy menstrual bleeding will not be covered in the Sexual and Reproductive Health strategy. However, the Government agrees that it is important for women to have access to support, including on information, diagnosis and treatment, for conditions such as heavy menstrual bleeding.The women’s health strategy will consider priorities for women’s health and further detail regarding the strategy will be announced in due course.

Coronavirus: Cumbria

Lord Walney: To ask Her Majesty's Government what plans they have to align the COVID-19 restriction level in Ulverston, Cumbria, with Barrow-in-Furness.

Lord Bethell: As of 6 January, all areas have been moved into tier 4 and the Government will review the tiering allocations every 14 days.